NUR 265 EXAM 4 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question 1.
Lupus: Hallmark sign
ANSWER
butterfly rash on face
Question 2.
Lupus: Indication of flare
ANSWER
Fever and fatigue
*also assess BUN function
*c reactive protein remains normal
Question 3.
Lupus: Interventions
ANSWER
-Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion
Question 4.
Lupus: medical management
ANSWER
-hydroxychloroquine(anti-malarial) decreases absorption of UV light
,Question 5.
Scleroderma
ANSWER
inflammatory, autoimmune connective tissue disease
Question 6.
Scleroderma: Hallmark Sign
ANSWER
Hard, leather-like edematous skin
Late: esophageal dismotility
Question 7.
Scleroderma: Assess
ANSWER
Swallow safety--esophageal dysmotility (ASPIRATION)
O2
circulation
skin
Question 8.
Scleroderma: Interventions
ANSWER
aspiration precautions (keep HOB at 60 degrees during meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol -avoid spices, caffeine and pepper
Question 9.
fibromyalgia: S/sx
ANSWER
i. extreme fatigure
ii. GI symptoms
iii. dysuria
iv. blurred vision
v. forgetfulness
,Question 10.
fibromyalgia: Assess
ANSWER
i. pain level
ii. extreme fatigue
iii. GI symptoms
Question 11.
Fibromyalgia: Interventions
ANSWER
NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)
promote sleep and low impact exercise (stretching, walking, swimming, rowing, water exercise)
Question 12.
Lyme Disease: Hallmark sign
ANSWER
stage 1: "bulls eye rash" and flu-like symptoms Stage 2: facial paralysis, carditis, meningitis
Question 13.
Lyme Disease: Assess
ANSWER
Skin
history of tick bites
, Question 14.
Lyme Disease: Interventions
ANSWER
prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars
Question 15.
Allergic Reaction Priority
ANSWER
STOP THE INFUSION/ELIMINATE the trigger, then STOP the immune response
Give Epi
maintain airway
Question 16.
Latex allergy: risks
ANSWER
-frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Question 17.
Anaphylactic shock
ANSWER
AIRWAY--give epi IV or IM STAT and intubate if needed
BREATHING--apply O2; mechanically ventilate CIRCULATION--monitor for distributive shock;
give fluids
CORRECT ANSWERS
Question 1.
Lupus: Hallmark sign
ANSWER
butterfly rash on face
Question 2.
Lupus: Indication of flare
ANSWER
Fever and fatigue
*also assess BUN function
*c reactive protein remains normal
Question 3.
Lupus: Interventions
ANSWER
-Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion
Question 4.
Lupus: medical management
ANSWER
-hydroxychloroquine(anti-malarial) decreases absorption of UV light
,Question 5.
Scleroderma
ANSWER
inflammatory, autoimmune connective tissue disease
Question 6.
Scleroderma: Hallmark Sign
ANSWER
Hard, leather-like edematous skin
Late: esophageal dismotility
Question 7.
Scleroderma: Assess
ANSWER
Swallow safety--esophageal dysmotility (ASPIRATION)
O2
circulation
skin
Question 8.
Scleroderma: Interventions
ANSWER
aspiration precautions (keep HOB at 60 degrees during meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol -avoid spices, caffeine and pepper
Question 9.
fibromyalgia: S/sx
ANSWER
i. extreme fatigure
ii. GI symptoms
iii. dysuria
iv. blurred vision
v. forgetfulness
,Question 10.
fibromyalgia: Assess
ANSWER
i. pain level
ii. extreme fatigue
iii. GI symptoms
Question 11.
Fibromyalgia: Interventions
ANSWER
NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)
promote sleep and low impact exercise (stretching, walking, swimming, rowing, water exercise)
Question 12.
Lyme Disease: Hallmark sign
ANSWER
stage 1: "bulls eye rash" and flu-like symptoms Stage 2: facial paralysis, carditis, meningitis
Question 13.
Lyme Disease: Assess
ANSWER
Skin
history of tick bites
, Question 14.
Lyme Disease: Interventions
ANSWER
prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars
Question 15.
Allergic Reaction Priority
ANSWER
STOP THE INFUSION/ELIMINATE the trigger, then STOP the immune response
Give Epi
maintain airway
Question 16.
Latex allergy: risks
ANSWER
-frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Question 17.
Anaphylactic shock
ANSWER
AIRWAY--give epi IV or IM STAT and intubate if needed
BREATHING--apply O2; mechanically ventilate CIRCULATION--monitor for distributive shock;
give fluids
